Identifying factors that influence physical activity (PA) among individuals with Down syndrome is essential for PA promotion. Insight can be gained from guardians and health professionals. The purpose of this study was to explore the perspectives of guardians and health professionals on facilitators and barriers of PA in individuals with Down syndrome. Interviews were conducted with 11 guardians (five mothers, four fathers, and two legal guardians) and 11 professionals (four PA specialists, three physical therapists, and four occupational therapists). Grounded theory was applied. Barriers and facilitators fit the levels of the ecological model of health behavior: (a) intrapersonal (perceived rewards), (b) interpersonal (interaction), (c) community (availability of programs), (d) organizational (school systems), and (e) policy (education). Guardians and professionals agreed on the importance of enjoyment, interaction, and programs to promote PA. Differences between groups were identified at the organizational and policy levels. PA in persons with Down syndrome is influenced by interactions between individual and environmental factors.
Emma E. Schultz, Katerina Sergi, Gregg Twietmeyer, Nicolas M. Oreskovic, and Stamatis Agiovlasitis
Kelly P. Arbour-Nicitopoulos, Raktim Mitra, Ritu Sharma, and Sarah A. Moore
This study explored the association between socioecological factors and outdoor physical activity (PA) and play in children with disabilities during the COVID-19 pandemic. Parents (N = 133) completed a survey to report changes in their child’s outdoor PA and play during the pandemic (from prepandemic levels), and child, household, and neighborhood environment factors. Children with a PA-supporting parent and from multichild and White households had lower odds of reporting decreased outdoor PA. Children from multichild, higher income, married couple households and a PA-supporting parent had lower odds of decreased outdoor play. Living in neighborhoods with higher urbanization (i.e., high dwelling density, street intersections, and land-use mix) was associated with greater odds of decreased outdoor PA and play. Future research that uses larger and more representative samples of children with disabilities is needed to test for the multivariate effects of socioecological variables on outdoor PA and play.
Heidi Stanish, Samantha M. Ross, Byron Lai, Justin A. Haegele, Joonkoo Yun, and Sean Healy
The U.S. Report Card on Physical Activity for Children and Youth has tracked 10 physical activity (PA) indicators common to the Active Healthy Kids Global Matrix since 2014. This article expands on the U.S. report cards by presenting PA indicator assessments among children and adolescents with disabilities. Grades for indicators were assigned based on a search of peer-reviewed articles presenting nationally representative data. The Global Matrix 3.0 benchmarks and grading framework guided the process. Grades for overall PA, sedentary behaviors, organized sports, and school were F, D+, D+, and D, respectively. Insufficient evidence existed to assign grades to the remaining six indicators. There is a need in the United States for targeted PA promotion strategies that are specific to children and adolescents with disabilities. Without a commitment to this effort across sectors and settings, the low grades identified in this para report card are expected to remain.
Yu-Ting Tseng, Chia-Liang Tsai, Tzu Hsuan Wu, Yi-Wen Chen, and Yi-Hsuan Lin
This study examined whether table tennis as a method of sensorimotor training improves haptic and motor function and to what extent haptic function gain correlates with changes in motor ability in children with probable developmental coordination disorder (pDCD). Children with pDCD were randomly assigned to the table tennis and nontraining control groups. The children in the table tennis group received 36 sessions of table tennis training, including ball balancing, hitting the ball against the wall, strokes, and serving. Haptic sensitivity, acuity, and motor function domains were measured. The results showed a 41.5% improvement in haptic sensitivity in children exposed to table tennis training compared with 2.8% in those without training. This improved haptic sensitivity significantly correlated with motor function gain, suggesting that somatosensory gains occur simultaneously with changes in motor function in children with pDCD. This novel upper limb motor training approach may be an interesting method of sensorimotor training in neurological rehabilitation in children with pDCD.
AuraLea Fain, Benjamin Hindle, Jordan Andersen, Bradley C. Nindl, Matthew B. Bird, Joel T. Fuller, Jodie A. Wills, and Tim L.A. Doyle
This study aimed to validate a 7-sensor inertial measurement unit system against optical motion capture to estimate bilateral lower-limb kinematics. Hip, knee, and ankle sagittal plane peak angles and range of motion (ROM) were compared during bodyweight squats and countermovement jumps in 18 participants. In the bodyweight squats, left peak hip flexion (intraclass correlation coefficient [ICC] = .51), knee extension (ICC = .68) and ankle plantar flexion (ICC = .55), and hip (ICC = .63) and knee (ICC = .52) ROM had moderate agreement, and right knee ROM had good agreement (ICC = .77). Relatively higher agreement was observed in the countermovement jumps compared to the bodyweight squats, moderate to good agreement in right peak knee flexion (ICC = .73), and right (ICC = .75) and left (ICC = .83) knee ROM. Moderate agreement was observed for right ankle plantar flexion (ICC = .63) and ROM (ICC = .51). Moderate agreement (ICC > .50) was observed in all variables in the left limb except hip extension, knee flexion, and dorsiflexion. In general, there was poor agreement for peak flexion angles, and at least moderate agreement for joint ROM. Future work will aim to optimize methodologies to increase usability and confidence in data interpretation by minimizing variance in system-based differences and may also benefit from expanding planes of movement.
Nader Farahpour, Mahboube Alemzadeh, Mehri Mohammadi, Mohammadreza Rezaie, and Paul Allard
Left–right differential erector spinae (ES) muscle strengthening is required to correct ES muscle imbalances. The objective was to test the effect of 6 body positions on the differential activation of the ES muscles. In 14 able-bodied young women, using a surface electromyography system, the bilateral ES muscles activity at the third lumbar (ESL3) and the 10th (EST10) and 6th (EST6) thoracic vertebral levels was measured with the contralateral arm and leg lifted in the prone and quadruped conditions and with a single arm lifted in the quadruped position. Results showed that the activity of the ESL3 was symmetrical (P > .05) and significantly smaller than that of the thoracic ES muscles in all body positions (P < .01). The EST10 and EST6 were differentially activated in all tests (P < .001). Besides, the differential activation was higher in the contralateral-arm and -leg lift in the quadruped position than in the other positions. In conclusion, contralateral-arm and -leg lift and single-arm lift in the quadruped and prone positions are capable of differentially activating the ES muscles on one side more than the other side. Further studies are recommended to examine the effectiveness of these exercises on the correction of ES muscle imbalances in clinical populations.
Tomoya Ishida, Mina Samukawa, Yuta Koshino, Takumi Ino, Satoshi Kasahara, and Harukazu Tohyama
Asymmetry in knee extensor moment during double-leg squatting was observed after anterior cruciate ligament reconstruction, even after the completion of the rehabilitation program for return to sports. The purpose of this study was to clarify the association between asymmetry in the knee extensor moment and pelvic rotation angle during double-leg squatting after anterior cruciate ligament reconstruction. Twenty-four participants performed double-leg squatting. Kinetics and kinematics during squatting were analyzed using a 3-dimensional motion analysis system with 2 force plates. The limb symmetry index of knee extensor moment was predicted by the pelvic rotation angle (R 2 = .376, P = .001). In addition, the pelvic rotation and the limb symmetry index of the vertical ground reaction force independently explained the limb symmetry index of the knee extensor moment (R 2 = .635, P < .001, β of pelvic rotation = −0.489, β of vertical ground reaction force = 0.524). Pelvic rotation toward the involved limb was associated with a smaller knee extensor moment in the involved limb than in the uninvolved limb. The assessment of pelvic rotation would be useful for partially predicting asymmetry in the knee extensor moment during double-leg squatting. Minimizing pelvic rotation may improve the asymmetry in the knee extensor moment during double-leg squatting after anterior cruciate ligament reconstruction.
Ling Li, Yu Song, Maddy Jenkins, and Boyi Dai
Biomechanical behavior prior to landing likely contributes to anterior cruciate ligament (ACL) injuries during jump-landing tasks. This study examined prelanding knee kinematics and landing ground reaction forces (GRFs) during single-leg and double-leg landings in males and females. Participants performed landings with the dominant leg or both legs while kinematic and GRF data were collected. Single-leg landings demonstrated less time between prelanding minimal knee flexion and initial ground contact, decreased prelanding and early-landing knee flexion angles and velocities, and increased peak vertical and posterior GRFs compared with double-leg landings. Increased prelanding knee flexion velocities and knee flexion excursion correlated with decreased peak posterior GRFs during both double-leg and single-leg landings. No significant differences were observed between males and females. Prelanding knee kinematics may contribute to the increased risk of ACL injuries in single-leg landings compared with double-leg landings. Future studies are encouraged to incorporate prelanding knee mechanics to understand ACL injury mechanisms and predict future ACL injury risks. Studies of the feasibility of increasing prelanding knee flexion are needed to understand the potential role of prelanding kinematics in decreasing ACL injury risk.
Unai Latorre Erezuma, Maialen Zelaia Amilibia, Ander Espin Elorza, Camilo Cortés, Jon Irazusta, and Ana Rodriguez-Larrad
This study assessed the effectiveness of a passive back support exoskeleton during a mechanical loading task. Fifteen healthy participants performed a simulated patient transfer task while wearing the Laevo (version 2.5) passive back support exoskeleton. Collected metrics encompassed L5-S1 joint moments, back and abdominal muscle activity, lower body and back kinematics, center of mass displacement, and movement smoothness. A statistical parametric mapping analysis approach was used to overcome limitations from discretization of continuous data. The exoskeleton reduced L5-S1 joint moments during trunk flexion, but wearing the device restricted L5-S1 joint flexion when flexing the trunk as well as hip and knee extension, preventing participants from standing fully upright. Moreover, wearing the device limited center of mass motion in the caudal direction and increased its motion in the anterior direction. Therefore, wearing the exoskeleton partly reduced lower back moments during the lowering phase of the patient transfer task, but there were some undesired effects such as altered joint kinematics and center of mass displacement. Statistical parametric mapping analysis was useful in determining the benefits and hindrances produced by wearing the exoskeleton while performing the simulated patient transfer task and should be utilized in further studies to inform design and appropriate usage.